Kornimate/medical-research-clean huggingface dataset:
comparison between three norepinephrine bolus doses for management of post-spinal hypotension during ceaserian section for patients with preeclampsia

Conditions: Anesthesia; Adverse Effect; Cesarean Section Complications

Summary: maternal hypotension after subarachnoid block is a frequent and deleterious complication during lower segment caesarean section (lscs). prophylaxis against hypotension using vasopressors had become a standard recommendation. in mothers with preeclampsia, post-spinal hypotension is less frequent compared to healthy mothers; thus, the latest guidelines do not recommend using vasopressors in preeclampsia patients unless there is a hypotensive episode . the incidence of post-spinal hypotension in mother with preeclampsia is nearly 25%. the commonly used vasopressors during cs are ephedrine, phenylephrine, and recently norepinephrine. the use of ephedrine is usually accompanied with maternal tachycardia and foetal acidosis. phenylephrine (pe) had been the first line for prevention and management of maternal hypotension; however, its use in mothers with preeclampsia had not been adequately investigated. thus, the best vasopressor for management of hypotension in mothers with preeclampsia is unknown. norepinephrine (ne) is an alpha adrenergic agonist with weak beta adrenergic agonistic activity; thus, it does not cause significant cardiac depression as phenylephrine does. ne was introduced for use during cs with promising results when used as infusion and as boluses in healthy mothers . the use of ne boluses in management of hypotension in preeclamptic mothers was not adequately investigated. a dose 4 mcg ne was recently evaluated in preeclamptic mothers. in this study, we will compare 3 ne bolus doses (3 mcg, 4 mcg, and 5 mcg) in management of maternal hypotension after spinal block during cs in preeclamptic mothers.


Eligibility criteria:
inclusion criteria: * pregnant female with preeclampsia * age 18-40 exclusion criteria: * age less than 18 * age above 40 * patient refusal of spinal anesthesia * patient with eclampsia * patient allergy to anesthesia drugs or to ne
pimecrolimus cream 1% in adult patients with perioral dermatitis

Conditions: Perioral Dermatitis

Summary: an evaluation of the safety and efficacy of the calcineurin inhibitor, pimecrolimus cream 1%, in adult patients with perioral dermatitis. this study is not enrolling patients in the united states.


Eligibility criteria:
inclusion criteria: * clinically diagnosed perioral dermatitis associated or not associated with topical steroid use (the periorbital area may also be involved in addition to the perioral region) * minimum severity score (podsi) ≥ 4 * age 18 and older exclusion criteria: * ongoing use of the following treatments is not allowed after the start of study drug: oral tetracyclines, oral erythromycin, oral steroids and oral calcineurin inhibitors. all topical treatments of the face, including steroids, calcineurin inhibitors, metronidazole, tetracyclines, erythromycin and emollients (exception: dac basiscreme). * systemic immunosuppression * history of malignancy of any organ system, treated or untreated, within the past 5 years

Keywords: perioral dermatitis, pimecrolimus cream
the best way to improve the near visual acuity after zxr00 iol implantation

Conditions: Cataract; Near Vision

Summary: the best way to improve the near visual acuity after zxr00 iol implantation

zxr00 intraocular lens is a new type of iol that can achieve good continuous visual acuity. its characteristic is to improve the distance and intermedia visual acuity and maintain good visual quality while sacrificing the near visual acuity. previous studies report that there are mainly two ways to improve the near visual acuity of zxr00：1.bilateral implantation of zxr00 with micromonovision. 2. combined implantation of zxr00 and multifocal iols.this study aim to explore which is the best way to improve the near visual acuity after zxr00 iol implantation.

Eligibility criteria:
inclusion criteria: * age of 18-80 years * cataract surgery is planned * the operation was successful without any complications * implanted with zxr00 iols or zmb00 iols exclusion criteria: * the history of retinopathy or retinal surgery * irregular corneal astigmatism * regular corneal astigmatism of 1.00 diopter (d) or more * iris abnormalities * macular degeneration * neuro-ophthalmic disease * the history of ocular inflammation
the optimal oblique and axial angle of fluoroscope for superior hypogastric plexus block

Conditions: Chronic Pelvic Pain; Pelvic Malignancy; Superior Hypogastric Plexus Block

Summary: the recommended entry angle for superior hypogastric plexus block is different among references, and there is a need for suggesting a more accurate entry angle for this procedure. the investigators are trying to evaluate the entry angle for superior hypogastric plexus block by measuring these angle on the computed tomography image and apply these angle to the real patients.

superior hypogastric plexus block is a kind of sympathetic plexus block which are used to control the pelvic pain caused by malignancy or other chronic condition. classic posterior approach for this procedure is inserting the block needle at l4 -5 level and proceed the needle 45 degrees medially and 30 degrees caudally to reach the target of anterolateral space of l5 - s1 intervertebral space. waldman et al. introduced a different angle of 30 degrees medial and caudal with the same approach, while stevens et al. recommended 15 degrees medial and 20 degrees caudal. as such, the recommended angle for this procedure is different among references, and there is a need for suggesting a more accurate entry angle for this procedure. therefore, we are trying to evaluate the entry angle for superior hypogastric plexus block by measuring these angle on the computed tomography image and apply these angle to the real patients.

Eligibility criteria:
inclusion criteria: * those undergoing abdominopelvic ct scan with pelvic malignancy or chronic pelvic pain with constitutional disease exclusion criteria: * poor ct image with non-measurable axial or oblique entry angle

Keywords: superior hypogastric plexus block pelvic malignancy chronic pelvic pain
comparison of visceral adipokines visfatin, vaspin and omentin levels in gestational diabetes mellitus pregnant women

Conditions: Gestational Diabetes; Obesity; Visceral Obesity

Summary: the prevalence of maternal obesity is increasing rapidly worldwide and constitutes an important obstetric problem that increases mortality and morbidity in both mothers and infants. obese women are prone to pregnancy complications such as gestational diabetes mellitus (gdm), and children of obese mothers are more likely to develop cardiovascular and metabolic disease later in life. the risk of developing gdm in obese pregnants is 1.3-3.8 times higher than in pregnant women with a normal body mass index, and approximately 70% of women with gdm remain at risk of developing type 2 diabetes until 28 years postpartum. gestational diabetes mellitus (gdm) affects approximately 6% of pregnant women and its prevalence is increasing in parallel with the obesity epidemic. gdm is associated with an increased risk of adverse pregnancy outcomes, including macrosomia, preterm delivery, neonatal hypoglycemia, neonatal jaundice, and congenital anomalies. it is also associated with a higher incidence of type 2 diabetes mellitus after birth. it is known that visceral adipose tissue increases in obese women. it is thought that there is a relationship between visceral adipose tissue increase and diabetes. in this study, the levels of new adipocytokines such as visfatin, vaspin and omentin secreted from visceral adipose tissue in patients diagnosed with gdm will be measured.

the investigators aim in this study the levels of visfatin, vaspin and omentin secreted from this tissue in pregnant women diagnosed with gdm by oral glucose tolerance test (ogtt) between 24-28 weeks of gestation and to determine if there is a relationship between these parameters. for this purpose, , and 87 pregnant women with gestational diabetes diagnosed at 24-28 weeks from the same patient group will be included in the study. . the same number of non-gdm control group pregnant women will also be included in the study at 24-28 weeks. age, gestational week, pregnancy history (gravida, parity, abortion, missed, ectopic), medical history, preconceptional bmi, current bmi, triglyceride, vldl, hdl, ldl, cholesterol, homa-ir, c-peptide, insulin, hba1c levels will be saved. in the 2nd trimester, between 24-26 weeks, ogtt will be performed on the patients and the results will be recorded. visfatin, vaspin and omentin levels will be checked and recorded in patients diagnosed with gdm.

Eligibility criteria:
inclusion criteria: * \>18 years of age * at the 2.st trimester of pregnancy exclusion criteria: * history of with diabetes mellitus * morbidly obese pregnants * history of abdomen liposuction
feasibility of endoscopic thyroidectomy for thyroid carcinoma

Conditions: Thyroid Carcinoma

Summary: endoscopic thyroidectomy has been used to treat thyroid diseases in china. however, whether this technique is rational to treat thyroid carcinoma is still in controversy. the diagnosis of thyroid carcinoma is predominantly made according to intra-operative frozen section pathological examination in china. in this research, the investigators want to compare clinical index (blood loss, operation duration, number of lymph nodes dissected, complication rates, etc) between patients underwent endoscopic thyroidectomy ( total thyroidectomy) and those underwent conversion to open procedure. the investigators want to evaluate the technical feasibility of endoscopic thyroidectomy for treating thyroid carcinoma.

intra-operative diagnosis of thyroid carcinoma is usually considered the indication of conversion to open surgery. with accumulation of experience of endoscopic thyroidectomy, the investigators want to evaluate the technical feasibility, completeness and safety of endoscopic thyroidectomy.

Eligibility criteria:
inclusion criteria: * lesion diameter less than 1 cm by ultrasound exclusion criteria: * frozen section diagnosis indicates benign lesion

Keywords: endoscopic thyroidectomy thyroid carcinoma
a pilot project to assess the impact of diabetes education during ophthalmology visits

Conditions: Diabetes Complications; Diabetic Retinopathy

Summary: the overarching purpose of this project is to provide diabetes education to the diverse patient population at the lions eye clinic, a resident-run ophthalmology practice at california pacific medical center. because of high clinic volume in a teaching environment, our patients often experience long wait times. the goal of this program is to utilize this wait time for diabetes education, a much-needed corollary to the eye care that patients receive at our clinic. this pilot project will investigate the impact of a program like this in our patient population. specifically, the investigators are investigating whether diabetes education delivered in an ophthalmology setting enhances patient understanding of diabetes (via knowledge surveys) and/or leads to improved blood glucose control (via hemoglobin a1c). this is a 6-month study that runs through april 2015, and looks at the impact of an interactive diabetes education ipad app +/- in-person sessions with a diabetes educator. a subset of patients who meet with a diabetes educator will also be shown their own retinal images (compared to a normal retina).


Eligibility criteria:
inclusion criteria: * type 1 or type 2 diabetes (as defined by evident systemic findings or recent hemoglobin a1c or patient report, as specific blood sugar data and knowledge of particular medications are often limited in this population) * age 18-75 * able and willing to provide informed consent * speak english, spanish, or any other language for which a translator is present exclusion criteria: * advanced visual acuity loss in both eyes which prevents adequate use of educational tools * pregnant women, elderly patients (\>75 years old), children and adolescents (17 or younger) * non-english/spanish speakers for whom a translator is not present
spinal cord stimulation to restore cough

Conditions: Spinal Cord Injuries; Spinal Cord Diseases; Paralysis; Central Nervous System Diseases; Cough; Trauma, Nervous System; Wounds and Injuries

Summary: the purpose of this trial is to determine the efficacy of spinal cord stimulation to produce an effective cough in patients with spinal cord injuries.

patients with cervical and thoracic spinal cord injuries often have paralysis of a major portion of their expiratory muscles - the muscles responsible for coughing - and therefore, lack a normal cough mechanism. consequently, most of these patients suffer from a markedly reduced ability to clear airway secretions, a factor which contributes to the development of recurrent respiratory tract infections such as pneumonia and bronchitis. expiratory muscles can be activated by electrical stimulation of the spinal roots to produce a functionally effective cough. the purpose of this trial is to determine if electrical stimulation of the expiratory muscles is capable of producing an effective cough on demand. according to the trial researchers, if successful, this technique will prevent the need for frequent patient suctioning - which often requires the constant presence of trained personnel. it will also allow spinal cord injured patients to clear their secretions more readily, thereby reducing the incidence of respiratory complications and associated illness and death. in the trial, researchers will study 18 adults (18-70 years old) with spinal injuries (t5 level or higher), at least 12 months following the date of injury. after an evaluation of medical history, a brief physical examination, and initial testing, participants will have small electrodes (metal discs) placed - by a routine surgical procedure - over the surface of their spinal cords on the lower back to stimulate the expiratory muscles and restore cough.

Eligibility criteria:
inclusion criteria: * stable spinal cord injury t5 level or higher * expiratory muscle weakness exclusion criteria: * significant cardiovascular disease * active lung disease * brain disease * scoliosis, chest wall deformity, or marked obesity

Keywords: spinal cord injury paralysis cough cervical spinal cord injury thoracic spinal cord injury
effect of sodium bicarbonate buccal infiltration on the success of inferior alveolar nerve block

Conditions: Local Anesthesia

Summary: the purpose of this prospective, randomized, double blind study was to evaluate the effect of a buccal infiltration of sodium bicarbonate on the anesthetic success of the inferior alveolar nerve block (ianb) in patients with mandibular first molar experiencing symptomatic

several studies have been done by adding sodium bicarbonate to local anesthesia in dentistry based on the theory that the amount of local anesthetic in the free-base un-ionized form will decrease to provide greater lipid penetration of the nerve and this could be cause of the failure of local anesthesia injected into the inflamed tissue with low ph and conflicting results were obtained. but, there are no study that evaluate effect of increasing ph in periradicular tissue on hindrance of resistance channels with supplementary infiltration injection of sodium bicarbonate

Eligibility criteria:
inclusion criteria: * vital mandibular molar tooth * diagnosis of symptomatic irreversible pulpitis exclusion criteria: * younger than 18 years old * history of significant medical conditions * allergies to local anesthetics or sulfites * pregnancy * taking any medications that might influence anesthetic assessment * active sites of pathosis in area of injection * inability to give informed consent

Keywords: inferior alveolar nerve block irreversible pulpitis local anesthesia sodium bicarbonate
correlation of structure and function in glaucoma

Conditions: Glaucoma

Summary: the aim of the study is to correlate structure and function in patients with glaucoma. to this end, a cross-sectional study unsing perimetry and optical coherence tomography is performed.


Eligibility criteria:
inclusion criteria: - diagnosis of glaucomatous optic neuropathy exclusion criteria: * age \< 18 years * diabetes * pregnancy * hypertensive retinopathy * smoking * intraocular surgery 1 month prior to study entry * systemic or ocular disease, excluding glaucoma, which the investigator believes could affect the test results * insufficient quality of the optical coherence tomography imaging * insufficient cooperation during examinations or measurements
acute mechanisms of cervical transcutaneous electrical stimulation of the spinal cord

Conditions: Spinal Cord Injuries

Summary: the purpose of this study is to examine how delivery of subthreshold electrical stimulation of the spinal cord alters the excitability of neural pathways and consequently movement performance in healthy and spinal cord injured individuals. specifically, we assess how stimulation parameters such as electrode configurations and stimulation frequency affect spinal excitability, corticospinal excitability, intracortical excitability, motor unit properties and force production. this study is not an intervention study, but a mechanistic study trying to shed light on how this novel neuromodulatory technique acutely affects the central nervous system.


Eligibility criteria:
inclusion criteria: * cervical level injury (c5 to c7) * at least 1 year post-injury exclusion criteria: * individuals with damage to the nervous system other than to the spinal cord * pregnant women (effects of stimulation on the fetus are unknown). transcranial magnetic stimulation-specific exclusion criteria: * participants with active or inactive implants including cardiac pacemakers, implantable defibrillators, ocular implants, deep brain stimulators, vagus nerve stimulator, and implanted medication pumps * participants with conductive, ferromagnetic or other magnetic-sensitive metals implanted in their head * participants with a history of seizures or epilepsy * participants taking any medication which may reduce seizure threshold
clomiphene citrate, estradiol and sildenafil for induction of ovulation in unexplained infertility

Conditions: Female Infertility

Summary: diagnosis of unexplained infertility is made after the recommended testing fails to reveal any abnormality. the treatment for unexplained infertility is empiric because it does not address a specific defect or functional impairment. the principal treatments for unexplained infertility include expectant observation with timed intercourse and lifestyle changes, clomiphene citrate and intrauterine insemination (iui), controlled ovarian hyperstimulation (coh) with iui, and ivf).

clomiphene citrate has been widely used alone, and in combination with intrauterine insemination (iui), for treatment of unexplained subfertility, the mechanism of action is based on its mixed estrogenic and antiestrogenic properties. clomiphene is frequently used to treat unexplained female infertility by inducing multifollicular response and correcting potential subtle ovulatory dysfunction .,)the american society for reproductive medicine,2003). the use of clomiphene citrate decreases the uterine blood flow during the early luteal phase, a periimplantation stage., )the american college of obstetricians and gynecologists,1995). although ovulation is found in 80% of women with a cumulative effect in 6-8 months, the pregnancy rate can still be very low in these women . the possible causes are the anti-estrogenic effects of cc at the endometrium and cervical mucus level . the endometrial effect is without doubt one of the most important handicaps in infertility treatment. the pregnancy rate can be very low, especially if the endometrial thickness (et) is \<6-8 mm ., )j turk ger gynecol assoc. ,2012). ethinyl e2 reverse the deleterious effect of cc on endometrial development during the follicular phase. endometrial thickness was dependent on peak e2 concentrations in serum.,(richard p. dickey, et.al.,2003). sildenafil citrate could lead to an improvement in uterine blood flow and, in conjunction with estrogen, led to the estrogen-induced proliferation of the endometrial lining . sildenafil citrate enhances uterine blood flow and increases endometrial thickening . the achieved implantation depends on the blastocyst's ability to infiltrate the endometrium and develop a sustaining blood supply, which requires the following genes to produce the necessary proteins for digesting the endometrial cellular matrix, to regulate cell growth, and to induce angiogenesis (razieh dehghani firouzabadi,et.al.,2013).

Eligibility criteria:
inclusion criteria: * women whose infertility tests were normal then diagnosed as unexplained infertility. exclusion criteria: * any cause of infertility male factor, tubal or ovarian. * chronic illness as cardiac or renal disease * any contraindication for used drugs
assessment of starch digestibility and amylase sufficiency in children

Conditions: Malnutrition, Child

Summary: research has demonstrated that there is a relationship between malnourishment and insufficient production of pancreatic enzymes, such as α-amylase which digests starch into glucose. starchy foods that can be easily digested into glucose are critical to the development child for energy and proper growth. this study investigated the use of a noninvasive breath test for the assessment of amylase sufficiency, digestibility of normal and modified sorghum porridges and gastric emptying rate of a sorghum porridge in malian and u.s. children.

the purpose of this research is to test the hypotheses that: 1.) moderately malnourished stunted children have low pancreatic α-amylase activity; and 2.) modified starchy food preparations will have better (higher) digestibility than the commonly given foods for both moderately malnourished stunted and healthy non-stunted children. a noninvasive breath test was used to assess amylase insufficiency in moderately malnourished and stunted children in mali, as well as in healthy children in mali and the united states. moderately malnourished and healthy children in mali were fed sorghum porridges, which are commonly consumed in mali. porridges contained a 13c-labeled substrate (algal starch or octanoic acid) for assessment of amylase insufficiency and gastric emptying rate. in a follow-up study, healthy children in the united states were also assessed for amylase sufficiency.

Eligibility criteria:
inclusion criteria: * stunted weaned children in the age range 18 - 30 months with height-for-age z-score (haz) below -2 (haz\<-2) * healthy, weaned children 18-30 months of age for study 1 * healthy, weaned children up to 5 years old exclusion criteria: * acutely ill and wasted child with weight for height lower than -2 z-score * no medical problems other than their malnutrition status * no medications